Is GRAND LAKE MENTAL HEALTH CENTER, INC. flagged for Medicaid fraud?

GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI: 1053317883) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does GRAND LAKE MENTAL HEALTH CENTER, INC. bill Medicaid?

GRAND LAKE MENTAL HEALTH CENTER, INC. received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in TULSA, OK.

What is NPI 1053317883?

NPI 1053317883 is the National Provider Identifier for GRAND LAKE MENTAL HEALTH CENTER, INC.. They are a Community/Behavioral Health provider based in TULSA, OK. This NPI is registered with the CMS NPI Registry.

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GRAND LAKE MENTAL HEALTH CENTER, INC.

Community/Behavioral Health·TULSA, OK·NPI: 1053317883Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $38.5M is at the 50th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-10→2024-12(51 months)

Total Paid

$38.5M

$38,512,288

Total Claims

58K

Beneficiaries

33K

1.8 claims/patient

Avg Cost/Claim

$660

Monthly Spending Trend

Yearly Spending

2018

$286

+186%

2020

$816

+353800%

2021

$2.9M

+272%

2022

$10.7M

+28%

2023

$13.7M

-19%

2024

$11.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 17 distinct procedure codes. The top code (H0019 (Behavioral health; residential, per diem)) accounts for 79% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0019Behavioral health; residential, per diemSee all providers →

$30.3M

33K claims

$920.06

$357.16

2.6×

Normal range

H0019Normal range

Behavioral health; residential, per diem

$30.3M

33K claims · 78.6%

Your Cost: $920.06/claim|Median: $357.16

2.6× median

H0010Alcohol and/or drug services, sub-acute detoxification, per diemSee all providers →

$6.7M

8,121 claims

$821.51

$369.55

2.2×

Top 25%

H0010Top 25%

Alcohol and/or drug services, sub-acute detoxification, per diem

$6.7M

8,121 claims · 17.3%

Your Cost: $821.51/claim|Median: $369.55

2.2× median

H2034Alcohol and/or drug abuse halfway house services, per hourSee all providers →

$324K

1,243 claims

$260.32

$164.03

1.6×

Normal range

H2034Normal range

Alcohol and/or drug abuse halfway house services, per hour

$324K

1,243 claims · 0.8%

Your Cost: $260.32/claim|Median: $164.03

1.6× median

99204Office/outpatient visit, new patient, mod-high complexitySee all providers →

$215K

1,465 claims

$146.69

$84.03

1.7×

Top 10%

99204Top 10%

Office/outpatient visit, new patient, mod-high complexity

$215K

1,465 claims · 0.6%

Your Cost: $146.69/claim|Median: $84.03

1.7× median

99205Office/outpatient visit, new patient, high complexitySee all providers →

$213K

1,154 claims

$184.62

$111.09

1.7×

Top 25%

99205Top 25%

Office/outpatient visit, new patient, high complexity

$213K

1,154 claims · 0.6%

Your Cost: $184.62/claim|Median: $111.09

1.7× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$184K

2,746 claims

$66.90

$37.81

1.8×

Top 25%

99213Top 25%

Office/outpatient visit, est. patient, low-mod complexity

$184K

2,746 claims · 0.5%

Your Cost: $66.90/claim|Median: $37.81

1.8× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$179K

1,774 claims

$100.77

$53.41

1.9×

Top 10%

99214Top 10%

Office/outpatient visit, est. patient, mod-high complexity

$179K

1,774 claims · 0.5%

Your Cost: $100.77/claim|Median: $53.41

1.9× median

99215Office/outpatient visit, high complexitySee all providers →

$147K

1,094 claims

$134.12

$74.09

1.8×

Top 25%

99215Top 25%

Office/outpatient visit, high complexity

$147K

1,094 claims · 0.4%

Your Cost: $134.12/claim|Median: $74.09

1.8× median

H0004Behavioral health counseling & therapy, per 15 minSee all providers →

$135K

2,229 claims

$60.59

$74.63

0.8×

Normal range

H0004Normal range

Behavioral health counseling & therapy, per 15 min

$135K

2,229 claims · 0.4%

Your Cost: $60.59/claim|Median: $74.63

0.8× median

87811SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-readSee all providers →

$94K

2,295 claims

$41.15

$30.53

1.3×

Top 10%

87811Top 10%

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$94K

2,295 claims · 0.2%

Your Cost: $41.15/claim|Median: $30.53

1.3× median

H0002Behavioral health screeningSee all providers →

$43K

1,766 claims

$24.19

$38.77

0.6×

Normal range

H0002Normal range

Behavioral health screening

$43K

1,766 claims · 0.1%

Your Cost: $24.19/claim|Median: $38.77

0.6× median

T1017Targeted case management, per 15 minSee all providers →

$23K

969 claims

$23.66

$69.56

0.3×

Normal range

T1017Normal range

Targeted case management, per 15 min

$23K

969 claims · 0.1%

Your Cost: $23.66/claim|Median: $69.56

0.3× median

H2015Comprehensive community support services, per 15 minSee all providers →

$12K

458 claims

$26.40

$96.24

0.3×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$12K

458 claims · 0.0%

Your Cost: $26.40/claim|Median: $96.24

0.3× median

H0032Mental health service plan developmentSee all providers →

$7K

81 claims

$80.96

$80.64

1.0×

Normal range

H0032Normal range

Mental health service plan development

$7K

81 claims · 0.0%

Your Cost: $80.96/claim|Median: $80.64

1.0× median

H0031Mental health assessment by non-physicianSee all providers →

$3K

29 claims

$101.95

$96.18

1.1×

Normal range

H0031Normal range

Mental health assessment by non-physician

$3K

29 claims · 0.0%

Your Cost: $101.95/claim|Median: $96.18

1.1× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$2K

18 claims

$94.66

$57.85

1.6×

Top 25%

99203Top 25%

Office/outpatient visit, new patient, low-mod complexity

$2K

18 claims · 0.0%

Your Cost: $94.66/claim|Median: $57.85

1.6× median

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

$818

37 claims

$22.10

$91.63

0.2×

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

$818

37 claims · 0.0%

Your Cost: $22.10/claim|Median: $91.63

0.2× median

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